Understanding Vitamin B12 Supplementation: Risks, Benefits, and Everything You Need to Know

Whether you have nerve damage, numbness in the limbs, or anemia, fatigue, memory loss, sleep disorders, irritability or depression, be careful that it may be a sign of vitamin B12 deficiency. There are a few things you really need to know about vitamin B12 supplementation, including: Who is at risk for vitamin B12 deficiency? Did you know that vitamin B12 on the market is divided into two categories: active and inactive? Can I take medical grade active vitamin B12 for a long time? Let pharmacist Zhao Shunrong take everyone to crack it once.

What is Vitamin B12?

Vitamin B12, also known as cobalamin cobalamin, is one of the eight B vitamins. It is an essential nutrient that the human body needs to obtain from food. It is a particularly important vitamin for maintaining the health of nerve cells. Pharmacist Zhao Shunrong, a master of pharmacy, pointed out that vitamin B12 helps the production of human genetic material DNA and RNA, maintains the normal operation of the nervous system, and can assist in the synthesis and metabolism of fatty acids, proteins, and carbohydrates.

What are the symptoms of vitamin B12 deficiency?

A severe deficiency of B12 can lead to nerve damage, and it is imperative to ensure that the diet contains enough B12. It can also have a major impact on preventing diseases such as anemia and dementia. Blood tests can be done to check the level of active vitamin B12 in the body. Vitamin B12 deficiency is rare in young people, but mild deficiency is common in older people, either because their diets are not as healthy or because their bodies need less stomach acid to absorb B12.

B group is a water-soluble vitamin, including: vitamin B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 ​​(pyridoxine), B7 (biotin), 8 kinds of water-soluble vitamins including B9 (folic acid) and B12 (cyanocobalamin).

Pharmacist Zhao Shunrong explained that the B group is a water-soluble vitamin, including: vitamin B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6 ​​(pyridoxine), B7 (biotin), B9 (folic acid) and B12 (cyanocobalamin), among which vitamins B12, B6 and B9 work together to control blood levels of the amino acid homocysteine, and high levels of homocysteine Cystine may be associated with heart disease and infertility. Numerous studies have shown that people with high levels of the amino acid isocysteine ​​are almost twice as likely to develop coronary artery disease and 2.5 times more likely to have a stroke compared to people with normal levels of the amino acid isocysteine. B-complex vitamins, especially vitamins B9, B6, and B12, help lower homocysteine ​​levels, which is one of the reasons why B-complex consumption is recommended.

Vitamin B12 deficiency is not only a problem for vegetarians, because fish, eggs and animal offal are the most abundant sources of vitamin B12, especially for the elderly.

Vitamin B12 deficiency is not only a problem for vegetarians, because fish, eggs and animal offal are the richest sources of vitamin B12, especially the elderly should be more concerned because they produce less stomach acid, which is effective Necessary for the absorption of B12. Without getting enough vitamin B12 from food sources, the body cannot function optimally and can lead to adverse symptoms. Some symptoms of B12 deficiency include:

-Extremely tired.

-anemia.

– Neurological features.

– Myelosuppression.

– feel dizzy.

– Pale skin.

– Mood changes (such as depression and/or irritability).

– palpitations.

– Mouth ulcers.

– Frequent itching or tingling of the tongue.

– Tingling in fingers and toes.

Who are the risk groups for vitamin B12 deficiency?

People at risk for vitamin B12 deficiency, including:

-Vegans and vegetarians.

– Crohn’s disease (inflammatory bowel disease).

– Diseases of the pancreas.

-A person whose weight loss surgery or medications affect the absorption of nutrients.

– People infected with Helicobacter pylori (which can cause ulcers).

– People with eating disorders.

– People living with HIV.

– Diabetics.

– Long-term use of antacids (gastroesophageal reflux medication).

-elder.

– Take birth control pills.

For healthy people without B12 deficiency, eating a comprehensive and nutritious diet should be able to provide what the body needs. However, those who take drugs that will affect the absorption of B12 or those who are pregnant or breastfeeding, as well as those who increase the demand for B12 due to chemotherapy, are all Consider talking to your doctor about taking a B12 supplement.

Food sources of vitamin B12 include: eggs, red meat, kako, seafood, milk, yogurt, seaweed, seaweed, various fermented soy products and yeast-derived foods, such as miso, fermented bean curd, tempeh, yeast-free beer, not fried at high temperature The stinky tofu and so on.

What are the food sources of vitamin B12?

Food sources of vitamin B12 include: eggs, red meat, kako, seafood, milk, yogurt, seaweed, seaweed, various fermented soy products and yeast-derived foods, such as miso, fermented bean curd, tempeh, yeast-free beer, not fried at high temperature The stinky tofu and so on.

What medications can lower vitamin B12 levels in the body?

Medicines that can affect vitamin B12 levels in the body include: antiseizure medicines, chemotherapy medicines, gout medicines, cholesterol-lowering medicines, medicines that reduce stomach acid, diabetes medicines, and antibiotics. In addition, long-term use of antibiotics can reduce the level of vitamin B in the body, especially at a different time from tetracycline antibiotics.

Due to potential side effects and drug interactions, dietary supplements should be taken under the supervision of a physician or pharmacist. Vitamin B12 is considered safe and nontoxic, but long-term use of any vitamin, especially active B12, may cause imbalances in other important B vitamins. In addition, taking high doses of folic acid may also mask vitamin B12 deficiency, so please consult your physician or pharmacist before taking more than 800 micrograms of folic acid a day.

What is the difference between regular B12 and medical grade active B12?

Vitamin B12 on the market can be divided into two main forms: “active B12” and “nutritional supplement/inactive B12”. Methylcobalamin (Methylcobalamin/ Mecobalamin) is active B12 and belongs to medical grade B12 and cyanocobalamin (cyanocobalamin) is inactive B12 and belongs to nutritional B12.

The main reason is that B12 binds to two proteins in the circulation in the body, one is haptocorrin and the other is transcobalamin. When combined with haptocorrin, it is not taken up by the cells for the body to use, so it is the inactive form of B12 that the body stores. Transcobalamin transports vitamin B12 into our cells, and when bound to this protein, vitamin B12 becomes methyl B12 or active B12, and total vitamin B12 refers to all the vitamin B12 in the blood.

Methylcobalamin (methylcobalamin) medical grade B12 is indeed higher in absorption rate and utilization rate in the body than cyanocobalamin (nutrient B12). Pharmacist Zhao Shunrong explained that studies have also found that after taking cyanocobalamin (nutrient B12), the rate of urine loss is three times faster than that of methylcobalamin (medical grade B12), because cyanocobalamin rises in the blood at the beginning. Potentially faster than methylcobalamin, but most of it is lost in a short period of time. Therefore, this is why medical experts recommend taking B-complex (including B12) supplements, and the significance of choosing a 10-hour sustained-release film-coated tablet product that has been “proven by a dissolution test”.

Pharmacist Zhao Shunrong reminded that although some studies have shown that high doses of B12 or active B12 may have adverse effects on the health of certain groups of people, if it is medically necessary to supplement B12 deficiency, it should still be used, as long as it is prescribed by a doctor or directed by a pharmacist side effects can be minimized.

Study: Too high blood levels of B12 linked to increased cancer risk

Research evidence shows that vitamin B12 deficiency is very common in the elderly, so adults over 50 years old should consider taking supplements, Pharmacist Zhao reminded, but for people without deficiency, it is not necessary to take large doses or use it for a long time, In particular, medical-grade active B12 (methylcobalamin/Mecobalamin) is not recommended for long-term use, because it may cause excessive levels of vitamin B12 in the body, causing a pile of idle DNA and protein in the body that may be related to cancer.

According to the JAMA “American Journal of Medicine” published in 2020, the association between vitamin B12 plasma concentration and all-cause mortality in the general population, this is from the University of Groningen University of Groningen in the Netherlands to prevent kidney and vascular disease research, with a total of 5571 participants. These findings suggest that higher vitamin B12 plasma concentrations are associated with an increased risk of all-cause mortality after adjustment for age, sex, renal function, and other clinical and laboratory variables.

The Strength of the Association Between Elevated Vitamin B12 and Solid Cancers Shown in the 2020 Journal of Clinical Medicine, an analysis of 1,570 medical documents from France, the United Kingdom and Denmark, confirms the role of B12 through research Abnormal elevations were significantly associated with the presence of solid cancers.

Can medical grade active B12 (methylcobalamin/Mecobalamin) be taken for a long time?

Active B12 can effectively treat peripheral neuropathy and improve symptoms such as pain and numbness. In the case of continuous medication, the blood concentration of methylcobalamin or total vitamin B12 increases with the increase in the number of medications. It should be understood that methylcobalamin is effective in humans. metabolic processes in the body. Moreover, the treatment of the disease should have its own course of treatment, and long-term blind medication is not suitable. Therefore, it is recommended that methylcobalamin should not be taken continuously for a long time. When your symptoms improve or disappear, you can reduce the use of methylcobalamin B12. Active methyl B12 does have additional benefits for peripheral nerve disorders, and other effects are no different from traditional vitamin B12. Moreover, active methyl B12 cannot be used as the main source of vitamin B12 alone, and traditional vitamin B12 must also be taken.

Pharmacist Zhao Shunrong reminded that although some studies have shown that high doses of B12 or active B12 may have adverse effects on the health of certain groups of people, if it is medically necessary to supplement B12 deficiency, it should still be used, as long as it is prescribed by a doctor or directed by a pharmacist side effects can be minimized. What we do worry about, like the researchers, is the unbridled increase in multivitamin intake for those who are not deficient. Especially multivitamins with added B1 and vitamin B6, although this vitamin is cleared by the kidneys. However, increasing the dose or using it for a long time may still cause physical load and unnecessary, so it is enough to supplement moderately, and keep in mind the correct concept of “seeing a doctor to see a doctor, and asking a pharmacist for medication”.

The application of alpha lipoic acid Lipoic Acid in neurology

Another supplement choice for adjuvant treatment of neuropathy is α-lipoic acid Alpha-Lipoic Acid (ALA for short). treatment goals. Lipoic acid has been used in the United States, Europe, and Japan to treat and improve type 2 diabetic neuropathy and wound healing, and peripheral neuropathy caused by nerve injury for more than 50 years. Studies have shown that brewer’s yeast (containing α-lipoic acid Liotic) can effectively alleviate peripheral neuropathy caused by cancer chemotherapy. Lipoic acid has been shown to be an anti-radiation treatment in a Russian hematological study. It not only brings a new gospel to the field of neuromedicine in Taiwan, but also provides more diversified choices for neurological health.